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We recently had a course attendee ask some great questions following the Myokinematic Restoration course.  Please check out Recent Emails to see the questions and answers!


Frequently asked question

We often have people ask us about the use of the words PRI and Postural Restoration Institute.  Most recently we received this email and decided to take the opportunity to educate everyone on this issue. 

“I have been hearing the phrase ‘doing PRI with my patients’ being used by some therapists for a while now.  I am not sure this is correct.  To me it sounds like the therapist is saying ‘doing Postural Restoration Institute with my patients’.  I could understand ‘using PRI methods’, or ‘PRI techniques’, but the active verb of ‘doing PRI’ doesn’t seem like the proper use of the PRI initialism.  I highly respect this approach but I also understand how language sometime evolves incorrectly (for example: ATM machines, PIN numbers, ITB band).”

“I have been doing PRI on my patients for years and the PRI has helped me teach PRI!”  This statement was said correctly.  PRI is a tradename, a brand, a label, etc. that reflects position, process or approach.  PRI is also an acronym.  The Postural Restoration Institute is the name of an Institute. Our attorneys are well versed in these issues.  You use Kleenex to blow your nose. It is a branded soft tissue. Its acronym stands for nothing, that I am aware of. PRI is a brand name, a “Kleenex” of an approach to restore posture or perform postural rehabilitation. It’s acronym in this form, grammatically, is meaningless.  Instead of calling this method or approach a different name, we decided to use the acronym of the Institute to “brand” it.  “Postural Restoration” does not brand an approach. “Pilates” is a form of postural restoration, as is “Feldenkrais”. There are hundreds of different approaches that could be used to restore posture.  Hope this helps you understand the legal world and world of PRI as an acronym and as a brand. 


Anterior Rotation of the Right Innominate vs. Left…

Anterior Rotation of the Right Innominate vs. Left…

We received this great question last week from a clinician who has attended a PRI course.  He brought up an interesting perspective…

During a conversation with a colleague a confusing issue came up.  PRI stuff is interesting and one of the things that is most interesting to me is that they pretty much say “everyone has this presentation” (left anterior, tension in right hamstring, anterior tilt, etc…). If you have ever read Wolf Schamberger’s “Malalignment Syndrome”, he actually talks about the most common presentation being people anteriorly rotated on the right, posterior on the left - which is opposite to PRI’s thought process.  Who is right?  I think it is okay to notice trends (I have actually seen more people fall in the presentation from the Malalignment Syndrome - anterior rotation on right), but to group everyone into the same presentation is a bit strange.

It’s all a matter of perspective, which is what PRI challenges the most.  Humans lateralize their center of gravity to the right more than to the left because of many objective reasons.  If one establishes a neuromuscular pattern of stable, secure foundation through the right lower extremity, utilizing the right vastus lateralis, right hamstring, right adductors and right gluteus medius, you will find an anteriorly positioned or oriented innominate on the right.  Subsequently, the left ASIS may “feel” more anteriorly rotated on the left and possibly the evaluator may “find” the right innominate more posteriorly rotated on the right.  Inter-rater reliability in these situations, without further integrated objective testing is poor at best.  In this case, in standing, the evaluator would find more lumbar-thoracic lordosis on the left. 
If one becomes lordotic bilaterally, as often is seen with those who are tight and over-active with their posterior exterior chained paravertebrals (PEC patients) the right and left innominates move in an anteriorly rotated direction around the frontal axis going through both central acetabulums.  Discussing axis of the sacral rotation complex, varies in every individual and has no validation in today’s research.  This individual will now need to begin moving the left innominate out or externally rotated it around the vertical left SI axis to offset weight distribution to the right, resulting in:

  • Hyperactive right quadratus lumborum activity
  • Hyperactive left gluteus maximus and TFL
  • Hypermobility and possible laxity of left pubefemoral and iliofemoral ligament and soft tissue
  • Inhibition of left adductor and hamstrings
  • A left ASIS that feels “posteriorly” rotated compared to the “anteriorly” rotated right innominate

I am fairly certain, this compensatory activity associated with the human characteristic pattern of bilateral innominate anterior rotation (lumbar-thoracic lordosis) is what the “Wolf Schamberger’s Malalignment Syndrome” is all about.
Again, it’s all about perspective, position and pattern of the tester and the tested.  Please realize that palpating ASIS’s and PSIS’s of those in sitting, standing, on one leg, supine, etc all result in various, ambiguous outcomes…a whole different discussion and set of circumstances. 


PRI Illustrations by Elizabeth Cunningham

PRI Illustrations by Elizabeth Cunningham

Over the past 10 weeks we have had the privilege to work with an incredible illustrator, Elizabeth Cunningham.  In her short time here, she has finished several amazing illustrations that were inspired by the science behind the Postural Restoration Institute.  She has also developed images for the coloring sections of our Myokinematic Restoration and Cervical-Cranio-Mandibular Restoration courses.  We are sad to announce that this will be her last day here at PRI but we are happy to know our relationship will continue while she pursues a career in Boston. 


Haven’t we all wondered this?

In a conversation between Ron Hruska and his daughter living in New York City, Ron describes why we associate smells with memories:

  • “Hi Rachelle! I enjoyed reading your tumbler message to me about the dry cleaners smell of your oxford shirt and the memories it stirred up.  I walked by a bakery in Warsaw and immediately thought of grandma Rita because of the bakery aroma.  When I smell tractor grease I immediately think of my dad and when I smell freshly cut alfalfa in the field I immediately think of my grandpa John.  When I smell freshly turned soil in the garden I think of grandma Rose and picking up potatoes that were just dug up, when we were little. When I smell new crayons exposed for the first time by opening their box lid I think of my school days at Dist. 31.  These smells are so precious to me. These odors and smells enter the nose and are recognized by the olfactory sensors and the signals are sent to the olfactory bulb that is located right above the eyes.  From there the sorted smell information is then sent to the limbic system, the primitive part of the brain that includes areas that control emotions, memory and behavior.  As the same information goes to the cortex or the outer brain for conscious thought, it is sent to the sensory cortex to create the sense of flavor.  The message sent to the cortex and the limbic system triggers memories that are stored in the hippocampus, and through relational memories your blue oxford shirt reminded you of me.  Thank God for the hippocampus! - Love Dad”


Visual Midline Shift Test

The Visual Midline Shift Test is located in our Advanced Integration course manual.  If you have recently been to an Advanced Integration course, you are familiar with this handout.  Eric Pinkall, MPT, PRC recently caught a mistake located on the handout.  Click HERE to print off the updated version of the Visual Midline Shift Test.  You can see the corrections highlighted in yellow!


Who Should I Refer To?

We are often asked “When should I refer my patient to a neuro-optometrist vs. an optometrist”?  This issue is discussed in the Vision-Vestibular Integration Course.  We have created a handout to help you determine when to refer to both!  Click HERE to get a copy!


Class III and Class I Bite

We received a great email regarding treatment of an anterior class I and posterior class III bite.  To read about it click here or go to Recent Emails!


Left AIC Pelvis

Left AIC Pelvis

Look at all the asymmetry going on in this x-ray!  Notice the size difference in the obturator foramens, the asymmetry in the pelvic floor opening and the difference between the left and right head of the femurs.  This is a classic example of a Left AIC pelvis! 


Influence of Thoracic Airflow and Rib Rotation on Transverse Spine Position

Influence of Thoracic Airflow and Rib Rotation on Transverse Spine Position

James Anderson, MPT, PRC put together a diagram that shows the influence that respiration has on rib position and spinal orientation.  This handout can now be found in our Postural Respiration course when we discuss Superior T4 syndrome.  To look at this handout, click here!


Right TMCC Facial Observations

Right TMCC Facial Observations

Take a look at the most recent picture we have taken of a classic Right TMCC pattern!  Do you see what we see?

  • Fullness and bulging of the right lateral face (zygoma region) secondary to increase of frontozygomatic angle.
  • Right temporal indentation compared to the left (right temporal internal rotation, left temporal external rotation)
  • Forward, opened, wider, larger right orbit
  • More visible left flared ear
  • Larger and more opened right nostril (especially seen with right torsion)
  • Increased distance between side of face and lateral ocular angle on the right side
  • Elevated right eyebrow

If you are interested to learn more about this, register for a Cervical Cranio Mandibular Restoration course here!


Back in Time

For those of you familiar with PRI, we thought you would find this intriguing.  This diagram was presented in the first course given by Ron Hruska.  The course was given in September of 1995 and was called “Postural Reconstruction - An Integrated Approach to Treatment of Upper Half Musculoskeletal and Respiratory Dysfunction”.  This is literally, the first sketch of the Left AIC, Right BC and PEC chain


Accelerated Locomotion

In the Left AIC patterned individual, harnessing the crossed extensor reflexes on the right and optimizing the crossed extensor reflexes on the left is encouraged.

During flexion, activation occurs at the ankle (dorsiflexion), then continues up to the knee joint and the hip.  This is usually often seen on the left and why some coaches ask athletes to “cock the toe” or “pull toes up”. The ankle joint is the foundation of flexion.

Activation for extension starts at the hip and moves down to the knee and ankle, creating the leg drive commonly referred to as triple extension.  This is often seen on the right.

Which specific toe would you remove to create a functional obligatory Left AIC pattern?  Click here for the answer…


Seated Acetabular Soft Tissue Kinematic Influences

For those of you that have taken Myokinematic Restoration, page 35 discussing seated acetabular soft tissue kinematic influences on seated FA ER and IR is somewhat confusing.  Recently a therapist emailed their question regarding this page and here is James Anderson’s response…


Associated Osteokinematic and Arthrokinematic Positions

Associated Osteokinematic and Arthrokinematic Positions

Common positions that are associated with a Left AIC pattern is a much discussed topic in all of our courses, especially Myokinematic Restoration.  To help course attendees out and anyone trying to understand how the body compensates for this pattern, James Anderson, MPT, PRC created a “user friendly” handout.  This diagram is now included in our Myokinematic Restoration course to help teach and educate!  To access the complete handout, click here!


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